Provider Demographics
NPI:1477132322
Name:KLINE, CHRISTOPHER DONALD (PHD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:DONALD
Last Name:KLINE
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:180-24 DOGWOOD TRL
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:OH
Mailing Address - Zip Code:44202-9183
Mailing Address - Country:US
Mailing Address - Phone:330-554-9589
Mailing Address - Fax:
Practice Address - Street 1:8040 CORPORATE CIR STE 4
Practice Address - Street 2:
Practice Address - City:NORTH ROYALTON
Practice Address - State:OH
Practice Address - Zip Code:44133-1283
Practice Address - Country:US
Practice Address - Phone:440-907-1141
Practice Address - Fax:440-345-3456
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-07
Last Update Date:2021-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4478103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty